Acute Respiratory Tract Infections and Mannose-Binding Lectin Insufficiency During Early Childhood

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Abstract
Acute respiratory tract infections (ARIs) are among the most prevalent infections in childhood worldwide, with the highest incidence among children younger than 2 years.1,2 Risk factors for these infections include being male, living in crowded conditions, and being exposed to child care centers and passive smoking.1,3 However, these factors explain only a fraction of the variation in incidence between children. Mannose-binding lectin (MBL) is a serum protein believed to play an important role in the innate immune response.4 A single gene, MBL2, located at chromosome 10, codes for human MBL.5,6 Mannose-binding lectin may exert its action through binding to high mannose and N-acetylglucosamine oligosaccharides present on a variety of microorganisms, thereby activating the complement system by MBL-associated serine proteases and interacting with novel receptors on phagocytes.7-9 As part of the innate immune system, the protein is considered particularly important in the vulnerable period of infancy before adequate specific immune protection is established by the adaptive immune system.10